<style type="text/css">
    .layui-layer-page .layui-layer-content{
        overflow: initial;
    }
</style>
<form style="padding:20px" class="layui-form normal" lay-filter="form-refund-apply" id="form-refund-apply" method="post" onsubmit="return false">
    <input type="hidden" name="id"/>
    <div class="layui-form-item">
        <label class="layui-form-label"><span class="text-danger">*</span>申请金额</label>
        <div class="layui-input-block">
            <input type="text" lay-verify="required|number" NUMBER="2" name="accountValue" class="layui-input required" placeholder="请输入退款金额"/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label"><span class="text-danger">*</span>收款银行名称</label>
        <div class="layui-input-block">
            <input type="text" lay-verify="required" name="payeeBankName" class="layui-input required" placeholder="请输入收款银行名称全称"/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label"><span class="text-danger">*</span>收款银行账号</label>
        <div class="layui-input-block">
            <input type="text" lay-verify="required" name="payeeBankAccountNo" class="layui-input required" placeholder="请输入收款银行账号"/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label"><span class="text-danger">*</span>收款银行地址</label>
        <div class="layui-input-block">
            <input type="text" lay-verify="required" name="payeeBankAddress" class="layui-input required" placeholder="请输入收款银行地址"/>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label"><span class="text-danger">*</span>申请退款原因</label>
        <div class="layui-input-block">
            <textarea name="memo" lay-verify="required" placeholder="请填写申请退款原因" class="layui-textarea"></textarea>
        </div>
    </div>
    <div class="layui-row">
        <button lay-submit lay-filter="refund-apply-save" class="layui-btn fr"><i class="iconfont iconicon-1"></i>&nbsp;保存</button>
    </div>
</form>